Oropharyngeal device

ABSTRACT

The oropharyngeal device has an extended body including a comparatively shorter approximately straight portion and a comparatively longer curved portion adjoining the straight portion. The extended body has a substantially constant U-shaped transverse cross-section along its entire length thus providing a U-shaped opening on one side thereof; a transverse securing flange attached to an end of the straight portion remote from the curved portion, one side of the transverse securing flange being provided with a U-shaped first recess, the first recess conforming to the U-shaped transverse cross-section of the extended body and positioned to provide a mouth for the U-shaped opening, and also with a C-shaped second recess in a side of the transverse securing flange remote from the side having the U-shaped first recess, the C-shaped second recess being dimensioned so that an endotracheal tube can be snapped in the second recess and held fixed therein; and a hard bite block formed integrally with the tube body and located in the vicinity of the straight portion, the bite block being made of a material also used for making the extended body.

BACKGROUND OF THE INVENTION

An oropharyngeal tube is fitted to a patient after intubation by atracheal tube and serves a number of purposes:

firstly it is intended to keep the airway open artificially and secondlyto allow a cannula to be introduced at any time via the tube for thepurpose of aspirating secretions, and furthermore, the tube should actas a bite block to prevent the inserted tracheal tube from beingsqueezed off or even bitten off.

In addition, the oropharyngeal tube should, as far as possible, hold thetongue and prevent it from falling back and closing the airways. Thisresults in the anatomical shape of the tube which comprises, insuccession as seen from the side, a transverse securing flange, which islocated externally on the patient's lips, an adjoining short,substantially straight portion and in turn, adjoining the latter, along, curved portion.

There are two fundamentally different types of pharyngeal tube:

The Berman type has an open cross-section, generally a T or double-Tprofile. Since it is not possible to incorporate a bite block, thisoropharyngeal tube is always made of a hard material.

The Guedel type has a closed, generally transverse oval cross-sectionalshape. Either it consists entirely of hard material or the actual tubeconsists of soft rubber or plastics, it being necessary to provide inthe region of the straight portion a bite block of hard material whichis generally a separate part that is pushed over the actual tube. Suchoropharyngeal tubes are described, for example, in the January 1978edition of the journal "Health Devices" in the article "ArtificialAirways" starting on page 67.

Furthermore, it is known to use such a tube also for securing theinserted tracheal tube, in that the holding means for the oropharyngealtube simultaneously holds the tracheal tube.

Such a solution, in which the holding means for the two tubes comprisesa rubber band extending around the patient's neck, is described in anarticle from "Der Anasthesit" (The Anaesthetist), Vol. 13, part 5, May1964, pages 172 and 173, Springer-Verlag, Berlin, under the title "Eineeinfache Haltevorrichtung fur Endotracheal-Katheter" (A simple holdingdevice for endotracheal catheters) by J. Schara, but the oropharyngealtube used therein is a known Guedel tube supplemented by an advantageousholding means.

The known oropharyngeal tubes have a number of disadvantages:

The closed cross-sectional shape of the Guedel type gives rise toproblems with the cleaning of the tube for reuse, since it is verydifficult to monitor the state of cleanliness.

Putting together the actual tube and an additional bite block isdisadvantageous, since the internal diameter is not uniform andtherefore there is a step between the bite block and the tube which

1. gives rise to poor throughflow rates,

2. creates a contamination site with the risk of infection,

3. gives rise to re-use problems because of the poor scope for cleaning,and

4. makes it relatively difficult to insert an aspiration catheter.

As a result of its cross-sectional shape the Berman type has a largenumber of free edges which, because it always has to be made of hardmaterial, can easily result in injury to the patient.

The described holding means also has shortcomings, since every time theholding means for the oropharyngeal tube is released the tracheal tubeis automatically also detached from its securing means, so that in sucha case the tracheal tube can very easily become dislodged or slip out.The greatest disadvantage is, however, that access to the mouth forcleaning purposes is almost completely blocked, and aspiration isdifficult to carry out, even via the tube. From the point of view ofmanufacture, this tube with the band is far too expensive.

It is an object of the present invention, therefore, to provide anoropharyngeal tube that is simple and risk-free in use, that isre-usable but is nevertheless simple and inexpensive to produce and,furthermore, enables the tracheal tube to be reliably secured.

According to the invention, the oropharyngeal device comprises anextended body having a comparatively shorter approximately straightportion and a comparatively longer curved portion adjoining the straightportion, the extended body having a substantially constant U-shapedtransverse cross-section along an entire length thereof to provide aU-shaped opening extending along one side thereof; a transverse securingflange attached to an end of the straight portion remote from the curvedportion; and a hard bite block formed integrally with the extended bodyand located in the vicinity of the straight portion. The bite block ismade of a material also used for the extend body. One side of thetransverse securing flange is provided with a U-shaped first recessconforming to the U-shaped transverse cross-section of the extended bodyand a second recess in a side of the securing flange remote from theside having the U-shaped first recess. The U-shaped first recess ispositioned in the securing flange to provide a mouth for the U-shapedopening. The second recess is C-shaped and is dimensioned so that anendotracheal tube can be snapped therein and held fixed therein.

In a preferred embodiment of the invention the extended body has a wallthickness such that the tube body is elastic over the entire lengththereof but cannot at least cannot be closed by compression orcompressed in operation. Preferably the wall thickness of the straightportion is twice the wall thickness of the curved portion.

The extended body in an additional embodiment can have a longitudinallyextending advantageously concave channel on a side opposite to theU-shaped opening, the channel having a base in alignment with a base ofthe C-shaped second recess.

Advantageously a smallest distance between the longitudinally extendingchannel and the U-shaped opening of the extended body is greater than awall thickness of the extended body. Also in a preferred embodiment aheight of the cross-section in the straight region of the extended bodyis greater in the vicinity of the smallest distance than in the vicinityof the U-shaped opening.

At least one perpendicularly projecting extension piece can be providedat the base of the C-shaped second recess extending from a side of thetransverse securing flange remote from the extended body. The extensionpiece can have a length approximately equal to at least a width of aplaster strip and has a thickened portion at a free end thereof. Thedevice can also have two fastening means for insertion into a fasteningband, the fastening means being attached to the transverse securingflange and extending from a side of the securing flange remote from theextended body. Each of the fastening means has a projecting nippleprotruding above and below a center of the transverse securing flangeand the transverse securing flange is provided with two eyelets throughwhich the fastening band can be passed.

Because the device of the invention is closed on one side and is open onthe other side, firstly it is possible to insert it easily and withlittle risk of injury and, secondly, the open side allows the insidesurface to be cleaned simply and thoroughly. Because the inside surfaceis constant and U-shaped, an aspiration catheter can be introduced intothe tube very easily, that is to say with little resistance.

In contrast, in the known tubes or devices the inside surface is reducedin the region of the bite block.

The fact that the bite block is made of the same material as the wholedevice and is formed integrally therewith simplifies and reduces thecost of manufacture which can then be effected using an injectionmolding process.

The material chosen is a plastics material which has adequate resistancewhere the material is thicker, such as in the region of the bite block,but which enables the material thickness chosen for the curved portionof the extended body to be such that there the extended body is elasticin its longitudinal direction, that is to say deviating from the curvedshape of its rest condition, while the U-shaped cross-section cannot bedeformed by any action of the intubated patient, that is to say there isno risk of this artificial airway becoming compressed.

The second recess in the securing flange and the C-shape thereof allowsa tracheal tube to be pushed in and locked into place. In addition tothis holding means, the tracheal tube can be secured, by strips ofplaster, to a corresponding extension piece extending outwards from thesecuring flange on the side remote from the extended body. The lengththereof must correspond to at least the width of the strip of plasterand there is preferably a thickened portion on the free end of theextension piece to prevent the plaster strip from slipping off.

The secure position of the tracheal tube on the oropharyngeal tube isfurther increased by a channel extending in the longitudinal directionon the narrow side of the central portion, which channel is located onthe narrow side opposite the U-shaped inside surface and in whichchannel a tracheal tube that is pressed into the C-shaped recess of thesecuring flange comes to rest. The channel has a curved cross-sectionalshape the base of which is in alignment with the base of the C-shapedrecess in the securing flange.

Bite protection is achieved by providing that the material thickness inthe region of the central portion between the U-shaped inside surfaceand the channel is always greater than the material thickness in theregion of the curved portion. In addition, the cross-section in thiscentral portion, seen in elevation, is greater than at the side in theregion of the U-shaped inside surface.

Furthermore, the extended body according to the invention can befastened using securing devices, preferably using nipples that projectforwards from the securing flange, by means of a rubber band around therear of the head or neck of the patient. A tracheal tube that is rigidlyconnected to the oropharyngeal extended body in the described manner isalso securely held thereby.

BRIEF DESCRIPTION OF THE DRAWINGS

An embodiment according to the invention is described in more detail byway of example in the drawings.

FIG. 1 is a side view of the oropharyngeal tube,

FIG. 2 is a plan view of the tube shown in FIG. 1 from below,

FIG. 3 is a cross-sectional view through the tube taken along thesection line A-B of FIG. 1,

FIG. 4 is a cross-sectional view through the tube taken along thesection line C-D of FIG. 1,

FIG. 5 is a cross-sectional view through the tube taken along thesection line E-F of FIG. 1, and

FIG. 6 is a front view of the securing flange.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIG. 1 shows in side view--like all positional details, referring to thein situ position of the device--the typical form of an oropharyngealdevice: in the side view it is possible to see the securing flange 1from which extend, in one direction, i.e. away from the patient, thenipples 15 for securing a rubber or fastening band 27, and the extensionpiece 13 with its thickened portion 14 at the free end, and the twoeyelets 20. In the other direction, adjacent to the securing flange 1,there is first a short, approximately straight portion 3 and in turn,adjacent to the latter, a long, curved portion 4, which portionstogether form the extended body 2. Where the short portion 3 merges intothe long curved portion 4 there is a slight kink, in conformity with theanatomical conditions at the site of use.

FIG. 2 shows the same oropharyngeal device viewed from below. At itsfree end, which is slanted relative to the longitudinal axis of theextended body and lies approximately perpendicular to the plane of thesecuring flange, the U-shaped opening 6 has a constant cross-sectionover the entire length of the tube body. In the region of the long,curved portion 4, the external contour 7 also is U-shaped, FIG. 2 alsoshowing the wall thickness 12 of the extended body at the free end,which thickness remains the same over the whole of portion 4, but inother embodiments can decrease towards the free end.

As shown by dotted lines in FIGS. 1 and 2, the U-shaped opening 6 isunchanged over the entire length of the extended body 2 and conformsalso to the first, U-shaped recess 8 in the securing flange 1 throughwhich proves a mouth for it.

In the region of the straight portion 3, the wall thickness is greaterthan the material thickness 12 in the curved portion, as can be seen inthe cross-sectional views in FIGS. 3 to 5:

Whereas the curved portion also has a U-shaped outer contour 7, thatouter contour changes at the point of transition into the straightportion, as shown in FIG. 4, to an approximately rectangularcross-section, the side thereof which is opposite from the open sidehaving a U-shaped opening 6 forms a shallow channel 10 extending in thelongitudinal direction of the extended body 2.

In the direction towards the securing flange 1, the wall thickness ofthe straight portion increases, as does also the depth of the channelopposite the open side, the cross-sectional shape of the channel beingconcavely curved.

This cross-sectional shape is shown in FIG. 3, and it can be seen thatin that region of the straight portion 3 the smallest distance 11between the deepest point of the channel 10 and the deepest point of theU-shaped opening 6 is considerably greater, by approximately a factor of2, than the wall thickness 12 in the curved portion 4 of the extendedbody. In addition, the wall thickness inside the cross-section, as shownin FIG. 3, increases from the free ends of the profile towards theregion remote therefrom, so that the thickness of the profile in theregion of the free ends is less than in the region of smallest distance11, where it is approximately twice the wall thickness 12.

Also in the straight portion 3 of the tube body the height 21 of thetube body in the vicinity of the smallest distance 11 is greater thanthe height 23 in the vicinity of the U-shaped opening 6.

As shown in FIG. 6, the cross-sectional shape shown in FIG. 3 isretained over the region of the short, straight portion 3 and is presentalso at the transition to the securing flange 1, where it opens, withouta step, into the U-shaped first recess 8, which corresponds to theU-shaped opening 6 of the extended body, and into a second, C-shaped,recess 9 that is located opposite this first recess 8 and is used forsnapping a tracheal tube into place. This C-shaped second recess is of adiameter smaller than the width of the channel 10 in the outer side ofthe straight portion 3, but the deepest point or base of the channel 10is in alignment with the deepest point or base of the C-shaped secondrecess 9. Also in alignment therewith is one edge of the extension piece13, which projects from the securing flange 1 in the direction away fromthe extended body, so that a tracheal tube that has been pressed intothe recess 9 can be secured by winding plaster or the like around theextension piece 13. In order to prevent an adhesive tape piece T fromslipping off, the extension piece 13 has at its free end a thickenedportion 14 which does not, however, extend into the region of theC-shaped recess 9 to prevent a tracheal tube from lying flat along theouter side of the extension piece 13.

Extending in the same direction are two nipples, arranged one above andone below the recesses 8 and 9, approximately in the center of thesecuring flange 1, which nipples likewise have a thickened free end butare shorter than the extension piece 13. The ends of the fastening orrubber band 27 provided with suitable slits can be pressed over thosenipples 15, the rubber band being fastened around the rear of the heador the neck of a patient to secure the oropharyngeal tube.

The combination of the manufacturing material chosen, for examplepolyethylene or EVA, together with the dimensioning of the oropharyngealdevice, has the result that the straight portion 3 is extremelyresistant, rigid and bite-resistant but the long curved portion 4 is notcompletely rigid but is somewhat elastic, so that the introduction ofthe device according to the invention is associated with little risk ofinjury to the patient. The rigidity of the curved portion 4 isnevertheless sufficient to prevent the open profile being compressed bythe muscle action of the patient.

While the invention has been illustrated and described as embodied in anoropharyngeal tube, it is not intended to be limited to the detailsshown, since various modifications and structural changes may be madewithout departing in any way from the spirit of the present invention.

Without further analysis, the foregoing will so fully reveal the gist ofthe present invention that others can, by applying current knowledge,readily adapt it for various applications without omitting featuresthat, from the standpoint of prior art, fairly constitute essentialcharacteristics of the generic or specific aspects of this invention.

What is claimed is new and desired to be protected by Letters Patent isset forth in the appended claims.

I claim:
 1. Oropharyngeal device comprisingan extended body including acomparatively shorter approximately straight portion and a comparativelylonger curved portion adjoining the straight portion, said extended bodyhaving a substantially constant U-shaped transverse cross-section alongthe entire length of the extended body to provide a U-shaped opening onone side thereof; a transverse securing flange attached to an end of thestraight portion remote from the curved portion, one side of thetransverse securing flange being provided with a U-shaped first recess,said first recess conforming to the U-shaped transverse cross-sectionthe extended body and positioned to provide a mouth for the U-shapedopening, and also with a C-shaped second recess in a side of thetransverse securing flange remote from the side having the U-shapedfirst recess, said C-shaped second recess being dimensioned so that anendotracheal tube can be snapped in the second recess and held fixedtherein; and a hard bite block formed integrally with the extended bodyand located in the vicinity of the straight portion, said bite blockbeing made of a material also used for making the extended body. 2.Oropharyngeal device according to claim 1, wherein the curved portionhas a wall thickness such that the extended body is elastic over theentire length thereof but cannot be closed by compression in operation.3. Oropharyngeal device according to claim 1, wherein the extended bodyhas a longitudinally extending channel on a side opposite to theU-shaped opening, said channel having a base in alignment with a base ofthe C-shaped second recess for the endotracheal tube.
 4. Oropharyngealdevice according to claim 3, wherein the channel is concave. 5.Oropharyngeal device according to 3, wherein a smallest distance betweenthe longitudinally extending channel and the U-shaped opening of theextended body is greater than a wall thickness of the extended body. 6.Oropharyngeal device according to claim 5, wherein a height of thecross-section in the straight region of the extended body is greater inthe vicinity of the smallest distance than in the vicinity of theU-shaped opening.
 7. Oropharyngeal device according to claim 3, furthercomprising at least one perpendicularly projecting extension pieceextending from the transverse securing flange oppositely from theextended body and from a position in the vicinity of the base of theC-shaped second recess.
 8. Oropharyngeal device according to claim 7,wherein the extension piece has a length approximately equal to at leasta width of an adhesive tape piece and has a thickened portion at a freeend thereof.
 9. Oropharyngeal device according to claim 1, furthercomprising two fastening means for insertion into a fastening band, saidfastening means being attached to the transverse securing flange andextending from the transverse securing flange oppositely from theextended body.
 10. Oropharyngeal device according to claim 9, whereineach of the fastening means has a projecting nipple protruding above andbelow a center of the transverse securing flange and the transversesecuring flange is provided with two eyelets.
 11. Oropharyngeal deviceaccording to claim 1, wherein a wall thickness of the straight portionis about twice as large as that of the curved portion.